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WALLINGFORD

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Rental Application

Please complete the form to apply for a room rental with us.

Wallingford Rentals - Rental Application

Date Needed*

Length of Stay*

First name*

Last name*

Email*

Phone*

Date of Birth*

Month

Day

Year

Rental History

Current Address*

Current Landlord Name*

Landlord Phone*

Employment Information

Current Employer

Employer Phone

Vehicle Information

Vehicle Make / Model

License Plate #

Emergency Contact Information

Emergency Contact Name

Emergency Contact Phone

Criminal Background Check Authorization

Have you ever been convicted of a felony?*

No

Yes

Are you a registered sex offender?

No

Yes

Signature

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Signature field is empty.

70 Wallingford Square,
Kittery, ME 03904 | 207-439-3351

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